A recent study shows that patients are getting, on average, five minutes or less to discuss a major health issue with their doctor.
Dr. Ming Tai-Seale of the Texas A&M Health Center led a team of doctors in a study that focused on elderly patients visits to their primary care physicians. Taking a unique approach, Dr. Tai Seale video-recorded 392 routine doctor office visits from multiple primary care practices in the U.S. These videotapes were then supplemented by patient and physician surveys.
All of the patients who participated in the study were aged 65 or older. The researchers found that the median time for visits was about 16 minutes, with five minutes dedicated to a major topic, and as little as a minute of time devoted to remaining health concerns.
The researchers discovered that a doctor has two choices when a patient presents a complex health problem during a routine appointment: they can either lengthen the visit by short-changing the next patient’s allotted time or limit the time spent discussing other concerns. Dr. Tai-Seale’s research team found that most doctors chose the latter option.
Dr. Tai-Seale acknowledged that some questions could be dealt with in a minute or less. However, “with only about two minutes of talk time on even the major topic from each speaker,” the research team wrote, “we could not help but wonder how much is accomplished during such a brief exchange.”
In a recent study published in the British Medical Journal, a random sample of 995 general practitioners in England and Wales were surveyed. The doctors were asked about 26 aspects of their practice. Of these doctors, 58% of them expressed concerns about not having sufficient time to attend to their practice.
When asked whether these concerns were directly related to having enough time to spend with each patient, the response varied from 17% for those with fewer than 1,500 patients to 45% for those with 3,000 patients or more. In turn, the number of consultations on a busy day was associated with various levels of frustration on both doctor and patient side, and low quality care.
Dr. S.H. Kaplan of the New England Medical Center, Primary Care Outcomes Research Institute has suggested that a doctor’s appointment should be at least 20 minutes long. This is the minimum amount of time needed to involve patients in decisions about treatment, to give them a sense of control, and to ask them to take some responsibility for their own care.
One recent development that may help ease frustrations on both sides of the “not enough time for patient appointments” argument is the use of the Internet. Doctors can now use the Internet to provide information through a practice web site and link patients with useful, valid, and relevant sources of information.
Internet communication between patient and doctor can encourage information flow, allow better scheduling of appointments, reduce unnecessary appointments, and avoid gaps in communication.
This may be an important development in patient/doctor relations, because if you’re like most patients, you no doubt value meaningful, repeated consultations with a trusted doctor.